Article

Surgery Today

, Volume 34, Issue 8, pp 719-724

Treatment Strategies for Perianal Rhabdomyosarcoma: Report of Two Cases

  • Yoshio WatanabeAffiliated withDepartment of Surgery, Ogaki Municipal Hospital
  • , Akihiro YamaguchiAffiliated withDepartment of Surgery, Ogaki Municipal Hospital
  • , Masatoshi IsogaiAffiliated withDepartment of Surgery, Ogaki Municipal Hospital
  • , Yuji KaneokaAffiliated withDepartment of Surgery, Ogaki Municipal Hospital
  • , Masahiko SuzukiAffiliated withDepartment of Surgery, Ogaki Municipal Hospital
  • , Hisami AndoAffiliated withDepartment of Pediatric Surgery, Nagoya University Graduate School of Medicine
  • , Keizo HoribeAffiliated withDepartment of Pediatrics, Nagoya National Hospital

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Abstract

Intensive chemotherapy and high-dose radiation with complete excision of the tumor are the treatment of choice for rhabdomyosarcoma (RMS). However, because there are so few reports of perianal RMS, a mainstream treatment has not been established. We report two cases of perianal RMS and review 13 cases documented in Japan since 1990. Case 1 was a 7-year-old boy first treated by tumor excision followed by chemotherapy and external irradiation. He has since been tumor-free but suffered severe perianal erosion and ulceration. Case 2 was a 17-year-old girl first treated by preoperative chemotherapy to reduce the tumor size, after which the tumor was completely excised with anatomical guidance using three-dimensional computed tomography via the posterior sagittal approach, followed by open intraoperative irradiation. She has since been tumor-free with preserved anal function. These case reports show the importance of cogitated treatments for preservation of anal function and optimal therapeutic outcome in patients with perianal RMS.

Key words

Perianal rhabdomyosarcoma Preoperative chemotherapy Posterior sagittal approach